Glaucoma Questions Answered by Eye Specialist

Any hazard to your eye can deprive you of your invaluable sight and sheen of life. However, you need to be gritty and always be on guard of any damage to your eyes. Glaucoma is one such eye related hazard that can make you blind! Glaucoma is the second leading cause of blindness across the world.

There would be many aspects of glaucoma, which you would like to know so that you could guard yourself against such an eventuality. The ‘Patient Education Booklet’ has been designed in such a way that the conversation between a Glaucoma patient and an Eye Specialist, would answer most of the queries you may have in your mind.

Patient: Dr. you have mentioned that I am suffering from Glaucoma. What exactly is Glaucoma?

Eye Specialist: Let me put it in simple words…our eyes functions as a ‘camera’, in which the retina is present like a film or reel of a camera. Whenever the sensitivity of the retina diminishes, as we call it ‘optic Neuropathy’ the patient towards blindness, gradually. It shortens the ‘visual field’ from the counters of vision, leading to gradual and permanent blindness. The loss of the vision is irreversible and permanent.

Patient: Dr. it is scary! Dr, what causes Glaucoma? How can one prevent Glaucoma?

Eye Specialist: Actually, our eyes contain a fluid called ‘Aqueous Humor’. This fluid flows across various parts within the eye and is regulated within a defined pressure in the eyes. In healthy individuals, the fluid flows at a constant pressure. However, if the fluid is obstructed due to few reasons, the pressure inside the eye increases and the posterior part of the eyes get severely affected. If the increases in the pressure and the proper drainage of the fluid is left uncontrolled for long, the risk of glaucoma increases.

Patient: Dr. What are the risk factors for Glaucoma?

Eye Specialist: The following table shows various risk factors for Glaucoma.

Strong Risk Factors

High eye pressure

Family history of Glaucoma

Age 40 and older for African Americans

Age 60 and older for general population, especially Mexican Americans

Abnormal optic nerve anatomy

Potential Risk Factors

High myopia (very severe nearsightedness)

Diabetes

Eye surgery or injury

Unfortunately most patients realize it late, when Glaucoma has already progressed more than 40%. To avoid the same, timely diagnosis and immediate treatment is necessary to check the progression of Glaucoma. You have been prescribed the following eye drops which you have to apply everyday as I advise you to do without fail.

Patient: I understand the seriousness of the disease. However Dr, I haven’t experienced any symptoms nor am I having any problem in my vision. Then, why do you say that I am suffering from a serious condition like Glaucoma?

Eye Specialist: Interesting question! In fact, Glaucoma is a ‘silent killer’ of vision. Most of the patients do not experience any problems initially and hence the patients don’t take the condition very seriously. Glaucoma gradually keeps pushing a patient towards absolute blindness. It is like a termite that eats away the vision gradually. Therefore, all our efforts are aimed to preserve your existing vision, as nothing can be done for the vision you have already lost. Thanks to the modern diagnostic methods like visual Field Test and Gonioscopy facilities early diagnosis. Taking your prescribed eye drops and other medications regularly prevents the patient from becoming blind. It is those patients who are ignorant or negligent about Glaucoma and the medication, who are likely to be a victim of blindness.

Patient: I haven’t observed any improvement in my vision, in spite of taking these medications regularly.

Eye Specialist: Yes, it’s a good observation. Unfortunately, as a patient diagnosed with Glaucoma, you are progressing towards blindness, and this medication is used to prevent it and not worsen the condition. If you do not use the prescribed medicines, you will continue to lose vision.

Patient: Dr. what would happen it I forget the medication?

Eye Specialist: It is very important that you do not forget or miss taking the medication everyday as recommended by me. Missing the dose of the prescribed medicine can be damaging.

Patient: Will the medication cure my Glaucoma after some time?

Eye Specialist: Once again, I repeat what I told you earlier – Glaucoma, just like diabetes or hypertension can’t be cured. Regular medication can only keep it in check. The purpose of taking the medication is to preserve your existing sight/vision and stop that from further worsening.

Patient: Dr. What about the cost of the medication. Are these medications expensive?

Eye Specialist: Good Question! There are inexpensive and expensive medication for treating Glaucoma. Older products may be cheap, but a few will have severe side effects and can affect your lungs and heart. Newer drugs may be expensive but they are safe to your lungs and heart. I am prescribing you a medication not just looking at your eyes, but overall health situation. I do not want you to take older medications for Glaucoma and spend huge amount for treating complications that might arise due to the use of these drugs.

Patient: What would happen to me in case I stop to use this medication after some time?

Eye Specialist: I presume you are a sensible patient. To answer your question, let’s go for an experiment. Keep your eyes closed for 15 minutes. I am sure you would be compelled to open your eyes within 5 minutes, as darkness surrounding you will make you frightened. Never ever make this darkness as a part of your life. Give more importance to your eyes so that you are self dependent.

Patient: I had an observation regarding the medication. As soon as I administer the eye drops, I observed that my eyes are red. I was worried, as to that has happened to my eyes, is something wrong?

Eye Specialist: Good question. Some of the latest medications can cause initial redness of the eyes. Do not get overly worried about the same, as the redness would disappear over a period of time. This redness is not harmful at all.

Patient: Dr, I also notice the change in the skin colour near my eyes.

Eye Specialist: Eye lash growth as well as pigmentation has been noticed in few patients using these type of drugs. Apply the drops as I have advised no need to worry.

Patient: Dr. When should I take the eye drops?

Eye specialist: Use the eye drops once daily, at the night time preferably at 9.00 o’clock.

Patient: Dr. how should I use the eye drops.

Eye specialist: Please follow the steps outlined below each time you use your eye drops.

Wash your hands thoroughly.

Immediately before using a bottle for the first time, remove any packaging and take the bottle out.

Remove the cap from the bottle

Hold the bottle upside down in one hand between your thumb and first finger.

Tilt your head back and look up.

Using your other hand, gently pull down lower eyelid from a pouch or pocket.

Place the dropper tip close to, but not touching your eye. Release one drop into the pouch/pocket formed between your eye and eyelid by gently squeezing the sides of the bottle.

Close your eye gently without blinking and press on the inside corner of your eye with the pad of your index finger for at least 2 minutes.

If necessary repeat these steps for your other eye.

Replace the cap on the bottle, closing it tightly.

Wash your hands again with soap and water.

It is important that you do not touch the tip of the bottle to any surface – this will help to make sure that your eye drops do not become contaminated.

Patient: Dr. you shared earlier regarding various diagnostic tests which are available for diagnosing Glaucoma. Could you share a few with me?

Eye Specialist: Amongst the various diagnostic tools available. Visual Field Perimetry and Gonioscopy and used commonly to evaluate the progression of Glaucoma.

Patient: Dr. one last question. How often should I visit and consult an eye specialist?

Eye Specialist:

Visit the eye clinic at least once every month.

Have your eye pressure checked.

If required your eye specialist may suggest a visual field test to evaluate any further loss of vision which could be done once in 3 – 6 months and readjust the medication.

Never stop or miss the prescribed medication without my advice.

Patient: Thank you Dr for clarifying my doubts and I promise you and myself that I will regularly take the medication and meet you for a regular check-up.

Eye Specialist: Because sunrise can not be heard. It can only be seen. Treat Glaucoma. Prevent Blindness.